I found your website and was very interested. Do you
have any natural remedies for someone with pseudomembranous
colitis (antibiotic associated colitis) who is suffering
from BV (bacterial vaginosis). I get very ill when I take
any of the antibiotics prescribed and currently have no
way to treat it and I am very concerned that it is not going
away.

Please let me know if you have any suggestions. Thank
you so much.

V.E.

Dear V,

This is a similar topic to our chronic diarrhea article (one of the most popular for some time). But it's different. We're dealing with a specific cause of stubborn
diarrhea and also the vaginosis. Since antibiotics are problematic
for you, we have to discuss alternative treatments.

Pseudomembranous Colitis (PMC) - An Antibiotic Colitis

PMC is a serious inflammation of the bowel lining with the formation of pseudomembranous plaques. The plaques are a yellow-green mucinous inflammatory exudate (yeah, I know, that's gross) that sit in patches throughout the lining of the colon and sometimes the small intestine.

PMC is an antibiotic-associated colitis. That means it happens after antibiotics unbalance the natural flora of the intestine. 1% of patients on antibiotics develop this condition.

Clostridium (C.) difficile, a "bad" bacteria, is normally
present in the bowel in small quantites. But when antibiotics
destroy the "good" bacteria, C. difficile overgrows.
Then it releases a powerful toxin that causes the symptoms of
PMC...

Symptoms of Pseudomembranous Colitis

Watery or mucoid green foul-smelling diarrhea

Urge to defecate

Abdominal cramps and pain

Low-grade fever (although it can reach 103-105 F)

There may also be:

Tenderness in the left lower quadrant of the abdomen (5-19%
of patients may have this tenderness without diarrhea. Stool
studies and CT scan aid in diagnosis)

Bloody stool

Signs of sepsis

Sepsis is hard to identify, but some signs and symptoms of it
are:

Malaise (ill feeling)

Fatigue

Fever

Rapid heart rate

Low blood pressure

Shock

I'm assuming your doctor already did a stool culture and got
a positive result for the C. difficile toxin, and did a colonoscopy
that showed the characteristic pseudomembranous plaques.

Conventional Treatment for PMC

Most commonly prescribed drugs are Metronidazole and Vancomycin.
Some other treatment are used too. Here is a chart to compare
them:

May relieve symptoms but result in more damage
to intestines by keeping the toxin inside

Lactobacillus GG

The most successful studies involve the use
of Lactobacillus GG at a dose of 1 x 1010 viable organisms
per day

Restores the natural flora to suppress the
C difficile

Lactobacillus GG alone, or the combination
of Bifidobacterium bifidum and Streptococcus thermophilus,
is effective in the treatment of Clostridium difficile. Oral
administration of probiotic compounds has been demonstrated
to be well tolerated and safe.

Complications

The more serious complications of PMC are cecal perforation,
toxic megacolon, hemorrhage, and sepsis. These can be life-threatening,
so don't play around! Make sure you're under the care of a competent
physician who can help you identify these before it's too late.

Alternatives to Antibiotic Treatment

I think the Lactobacillus GG is pretty exciting (it's
in the chart above). There are a number of studies that confirm
its effectiveness or at least say it's promising.

It basically replaces the friendly flora that the antibiotics
destroyed. The GG form can survive the stomach acid and make it
to your intestines. (Note: The acidophilus form has been shown
to be destroyed by stomach acid so it never reaches the place
you want it to!)

Lactobacillus GG:

Reduces the recurrence rate of Clostridium difficile

Patients feel better when taking Lactobacillus GG, as compared
with the placebo, and

Their abdominal cramps and diarrhea go away pretty quickly.

I'll give you this link. It may not be the only company that
offers GG, but I don't want you to accidentally buy a non-GG form
of Lactobacillus. Check out Culturelle.com.
No, I'm not making any money for referring you. Maybe I should!

Chinese Medicine Pseudomembranous Colitis Treatment

Now comes the fun part. What chinese herbal medicines can you
take for PMC?

If you've read the diarrhea article,
you may have noticed that the symptoms of PMC fit the chinese
medical disease Li Ji.

The Chinese Medical Disease: Li Ji

Li Ji (you can remember it by the rhyming word "leaky" - as in leaky... well you know!) can be divided into 6 major types.
It generally has the symptoms of:

Increased frequency of bowel movements

Tenesmus (straining to free the stool)

Abdominal Pain

Stool mixed with mucus, pus, and blood

However, the 6 types of Li Ji vary in their symptoms and signs.
Here's a table for ya:

recurring, no impovement over extended period
of time, tiredness, fatigue, lethargy, no appetite

Lian Li Tang

The first two "hot" patterns are probably well-treated
by antibiotics. The third hot type may require a kind of yin supplementation
that western medicine doesn't use.

As for the cold patterns... We generally think of antibiotics
as being cold in nature, so they would do well against the hot
type of Li Ji. However, the cold type might be worsened by a cold
medicinal like an antibiotic. (If these ideas of cold and hot
are confusing, read my article "Heat
and Chilled Coffee")

The point is: Western medicine is not as able to deal with cold
and/or deficient types of diarrhea. That means people with the
last 4 types of Li Ji should see a Chinese Medicine practitioner.

How to Get a Chinese Herbal Formula for PMC

Get thee to a Chinese Medical Physician. That's basically the
same as an acupuncturist. I call them that because many of them
practice chinese herbal medicine too (acupuncture's just one modality-
not the whole medicine), and in California (where we set the standards
for the rest of the country) acupuncturists are physicians by
law.

To find one near you, consult this
resource. Call them up and make sure they prescribe personalized
herbal formulas. Patents, tinctures, and pills might not do the
trick in this case. Don't forget- you need to fix the PMC
fast because the complications are grave, the end of the line
is surgery, and chances of death are much higher if it gets bad
enough to require surgery.

FYI, some of the typical herbs we put in the formulas to treat
Li Ji are:

Type of
Li Ji

Herbal Formula

Major Herbs in Formula

Damp-heat

Shao Yao Tang

Bai Shao Yao (White Peony root)

Huang Lian (coptis root)

Huang Qin (Scutellaria root)

Epidemic toxin

Bai Tou Weng Tang

Bai Tou Weng (Pulsatilla root)

Huang Bai (Phellodendron bark)

Yin vacuity

Zhu Che Wan

Huang Lian (Coptis root)

E Jiao (Donkey hide glue)

Cold-dampness

Wei Ling Tang

Cang Zhu (Atractylodes root)

Bai Zhu (Ovate Atractylodes root)

Fu Ling (Poria)

Vacuity-cold

Zhen Ren Yang Zang Tang

Ren Shen (Ginseng)

Bai Zhu (Ovate Atractylodes root)

Bai Shao Yao (White Peony root)

Chronic intermittent

Lian Li Tang

Ren Shen (Ginseng)

Bai Zhu (Ovate Atracylodes root)

Huang Lian (Coptis root)

Kitchen Medicine

You may notice that one of the cold types includes ginseng. Good
kitchen medicine (use of herbs in the kitchen) for the cold types
of Li Ji might include fresh ginger tea, ginseng, or even garlic.
These herbs are too hot for the hot types... those with hot Li
Ji should avoid spicy and greasy foods.

Bacterial Vaginosis

Bacterial infections (bacterial vaginosis) usually cause a thin
grayish discharge that has an unpleasant, fishy smell. This type
of infection may be spread by sexual contact, but not in all cases.
Treatment of this condition requires antibiotics from a doctor.

Symptoms:

You may notice a discharge from your vagina.

The discharge may be clear or colored.

It may be very light or heavy.

It may have a fishy smell, especially after you have intercourse.

Some women have bacterial vaginosis without any symptoms.

Is Sexually Transmitted?

It's not something you catch from someone else- it's an overgrowth
of normal vaginal bacteria. While it's more common in women who
are sexually active, it also occurs in women who are not sexually
active. It's not usually necessary for your sex partner to be
treated.

Complications

If the infection isn't treated, the bacteria may get up into
the uterus or the fallopian tubes and cause more serious infections.
Treating bacterial vaginosis lowers this risk. Treatment is especially
important in pregnant women.

Conventional Treatments

Treatment

Dosage

Cure rate

Metronidazole (Flagyl)

500 mg twice daily for seven days or 2 g
in a single dose

From 84 to 96 percent cure rate

Higher rate of recurrence with single
dose

Clindamycin

300 mg twice daily for seven days

94 percent

Clindamycin 2% vaginal cream

5 g at bedtime for seven days

86 percent (estimated)

Metronidazole vaginal gel

5 g twice daily or at bedtime for five days

75 percent

Alternative Treatments for Bacterial Vaginosis
(to be take with a figurative "Grain of Salt")

I found a number of other alternative treatments online- I must
say that I don't know how much they've been studied- someone out
there may have some info I don't... in which case I ask you to
email me about it.

First, some recommend to AVOID:

alcohol

coffee

fast foods

processed foods

refined flour products (bread, pasta, etc.)

saturated fats from animal products

sugar

However, a lot of people suggest avoiding those things at all
time for all conditions! Generally, unhealthy foods are harder
on the digestion system- maybe that's the point.

Chinese Medicine for Bacterial Vaginosis

Broken record- see a Chinese Medicine practitioner. There are
herbs that could be used as a douche, and there are internal herbal
approaches too. Probably the best approach would be to do both...
or to use an internal herbal formula for the PMC and an external
one for the vaginosis.